Hip and Glute Strength for IT Band Rehab

November 15, 2017

A couple years ago, I was plagued with iliotibial band syndrome (ITBS, or IT band syndrome). Once a runner is plagued with IT band syndrome, it’s a tough overuse injury to shake. No matter what I did or which chiropractor I saw, I couldn’t shake it. At its worst, my first marathon came to a grinding halt when my knee locked up completely and didn’t allow me to do anything except walk. And at its best, I could run/walk my second marathon. (Read more about ITBS in this post.)

Between my two marathons, I was referred to a physical therapist by my friend and sports medicine physician. At physical therapy, I was given a gait analysis and evaluation, and suggested exercises. I did the exercises diligently, yet was again plagued with IT band issues with my second marathon.

Would the injury cycle ever end?!

Frankly, my outlook looked bleak. I always did my strength work, and even added to it. My frustration was high. I was doing something wrong. But what was the something? And then one day while I was emailing my coach my frustrations, he mentioned that with all the exercises I was doing it seemed that I still wasn’t activating my glutes.

“Well now how could that be? Of course I’m activating my glutes,” I thought. But I wasn’t. Not by a long shot. It was then that I realized I really needed to focus my efforts on my hips and glutes.

Fire up those glutes!

Today I’m going to share my IT band rehab gems with you. There are lots of “routines” and exercises relating to IT band syndrome. Some may work for you, others may not. But for me, I found this routine and these tips to be a life-saver. It’s what works for me and if you’ve got a stubborn case of ITBS, it may work for you as well.

Please note: this post is for entertainment and educational purposes only. I am not a doctor or physical therapist. If you have pain when running, stop your activity and consult a medical professional.

Hip and Glute Strength for IT Band Rehab

Before we get into the nitty gritty, let me give you some general guidelines. This routine is best performed three times with a couple minutes of rest in between each set. This is not a HIIT workout. The movements should be slow and controlled, and you should focus on activating the small muscles responsible for stability and support. Keep your core engaged and focus your attention on the hips and glutes.

Push-ups

Engaging the core and glutes, perform 10-20 push-ups. If you can only do a few push-ups, that’s fine. The goal here is to maintain good form and not get sloppy.

Renegade rows

Grab an appropriate weighted dumbbell and place it next to you parallel to your chest. Get into high plank position, grab the dumbbell and perform rows. Again, maintain good form. If your body is twisting too much or wobbling back and forth, try less weight. Perform 10-15 rows on each arm.

Single leg star drill

This is a variation on an exercise used by physical therapists to help determine balance, stability, and muscle imbalances. Used in a slightly different way, it makes for a great hip and glute strengthening workout.

The goal of this drill is to maintain control of your knee while slightly squatting and moving the opposite foot in the various directions.

To get into position for this exercise, imagine a star formation like a clock face on the floor. (You can also create a star using masking tape on the gym floor.) You’ll plant your foot in the center of the star and perform the following single leg squats:

Anterior: Balancing on your right leg with your hands on your hips, engage your core and slightly squat and reach forward and touch your left toe on the ground directly in front of you (anteriorly). Do not plant the left foot, just lightly touch the toe. Then bring the foot back and stand up straight. Repeat this ten times.

Anterior toe touch

Anterior toe touch

Lateral: The next step is to move the left leg and foot to the side (laterally) and lightly touch the toe to the ground. Maintain balance on the right leg during these motions. Repeat this ten times.

Lateral toe touch

Lateral toe touch

Posterolateral: Next up is a posterolateral move — you’ll turn your body slightly as you watch your left toe touch the ground at about 45 degrees from the midnight on the clock face — which would put your left toe at about 7:30 on the clock face. Bring the leg back to the neutral position. Repeat this movement ten times.

Posterolateral toe touch

Posterolateral toe touch

You’ll want to slow down significantly during the posterolateral positioning. It will require significant concentration and effort to keep the standing leg balanced and the knee from wobbling. After all repetitions are completed on the right leg, switch sides.

Lateral leg lifts

Lie on your right side with your legs stacked. Lift your left leg up and slightly back without rotating your hips. Lower the leg. Repeat this action 20-30 times. You should really feel it in the glutes if you’re doing this one right. Switch sides.

Clam shells

Again lying on your right side, lock your heels together, lift your left knee up and back down, mimicking a clamshell. Repeat 20-30 times and then switch sides.

Single leg glute bridge

Lie on your back. Engage your core and glutes and raise your trunk in the air. Lift your left leg, bending at the knee. With your left leg in the air, raise and lower your hips 20 times. Lower your leg and trunk. Switch legs and repeat.

Be sure not to raise your trunk using your quadriceps or shoulders. Keep the quads and hammies loose. You want your core and glutes to do the work.

Mini squats with glute squeeze

Stand with your feet shoulder-width apart, hands on your hips. Lower into a squat position like you would sit on a chair, and then stand back up. When you get into the standing position, give your glutes a little squeeze. Do 25 of these.

Complete this circuit three times. Try to do this workout 3-4 times each week.

Additional Tips for IT Band Rehab

Before every run, be sure to activate the glutes. Weak gluteus medius muscles are a huge contributor to IT band issues. An easy way to activate the glute meds is to perform 20 small side circles — 10 forward and 10 backward — on each leg. The circles should be small and controlled and you should feel your gluteus medius activate. You can do this while waiting for your GPS watch to find satellites. Grab a mailbox and start making small circles on each side.

If you feel your IT band begin to pull or become sore while running, simply touch your glutes or poke them with your hand while running. The touch sensation will help to activate the muscle.

Another helpful tip:

If you suffer from ITBS, stop crossing your legs when you sit — and never cross them again. It’s possible that extending and putting pressure on your IT bands while sitting can be a contributing factor to IT band pain. You can cross your ankles if you need to cross anything.

Strengthen those hips and glutes!

Once you have IT band syndrome, it’s a tough overuse injury to kick. Since my issues were long and drawn out, I will always be at risk for it to come back. Thankfully when it does come now, I know what I need to do. Between my strength exercises, not crossing my legs, and mini side circles before a run — knock on wood — I haven’t had IT band pain for several months.

If you’ve got a stubborn case of IT band syndrome, strengthen your hips and glutes. It will help!

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61 Comments

It seems like weak glutes are the cause of so many injuries! This is one I’ve never had (knock on wood) but I still make sure to do glute exercises regularly. Side lying leg lifts and bridges are some of my favorites!

I’m a quad dominant person. It is so hard for me to activate my glutes. Marching bridge and monster walks always, always get my glutes firing. I do them before a run just to let those pesky buns wake up!

Knock on wood, no ITB issues ever, but lots of piriformis crap. Thankfully, the piriformis has been rather calm this past year, but (like your ITB) I know it’s just lurking and will reappear if I don’t play it cool. These exercises are great…thanks for the great explaining!

I have had issues with my ITB for over two years now, and I’ve been unable to run for over a year. I have weak hip flexors and glutes, and a physiatrist diagnosed me with gluteus medius tendinitis just this year. So I’m back to square one with PT. These are awesome exercises; bookmarking this page for reference. Thanks!

Oh no!!! Have you seen a chiropractor that specializes in sports performance? They can usually help with supplemental exercises as well as ART to help loosen up muscle tightness.

One tip — if someone has you doing squats and lunges, make sure you’re using your GLUTES and not your quads. I was doing squats and lunges for years and couldn’t figure out why they weren’t working. When I finally figured out the glute piece is when I finally stopped hurting.

I’ve seen two chiropractors. The one I’m currently seeing seems to think the problem is in my lumbar spine, but to be quite honest, the only thing that’s brought me some relief has been seeing someone specialized in the Rossiter technique. I’ll definitely look into another chiropractor; I’d like to be back running soon.

I don’t have IT band problems but these exercises will help prevent a lot of trouble with the low back, piriformis and other potential running injuries. I run my clients (even non-runners) through a short series of similar exercises before their workout just to wake up those glutes!

Great post! I’ve been lucky (knock on wood) to not have IT band issues, but I do have some other ongoing hip issues that could definitely use some glute/hip strengthening. Going to incorporate these in my routine!

This was my first ever running injury. I came from a background of regular strength training and still it happened because I ramped up mileage too fast too soon after my first marathon. I think it’s really important to give ITBS ample recovery time so it does not become chronic. Live and learn.

I had a half with IT woes — I didn’t really know what it was at the time, and my solution was to stop running right before the half. Bad decision. Which culminated in me walking the last 3 miles and being unable to walk (and certainly not run!) without pain for a long time afterward. I almost gave up on running halfs.

Like you, I did many things. I haven’t had as bad an experience again, but every once in a while it can still get cranky — in fact, right before Wineglass during the taper, out of the blue.

Taping is my secret weapon. I go months without having to tape anything and then months where I’m blazing through the tape, but it allows me to keep on running.

Taping is one of those things I tried and desperately wanted to work. Unfortunately with my first bought of ITBS (which sounds eerily similar to yours) I was so far gone that literally nothing would have helped me. If things start feeling cranky, I’ll sometimes tape but really getting to the chiro and focusing on glute strength works best for me.

Oh yes dealt with ITBS early in my running. I’m so quad dominant that glute and hip work will always have to be part of my routine. I’ve got many of these drills as part of my rotation, especially clamshells – evil little devils, but so necessary! Great post!

I’ve definitely had knee pain that I believe was related to ITB issues, but thankfully nothing that’s sidelined me for too long. One change I’ve made is doing exercises like these proactively to prevent injury. Thanks for sharing so many great moves!

Hi,
I think I have this ITB problem almost since a year and it took me some time to figure out what the problem is. Does this problem really reduce? I feel so depressed every time I think about my previous runs (10K).
I started the rehab procedure but when I do the clam shells and the lateral leg raises with the band, ITB still hurts while doing the exercise. Is it ok to still run while I am doing these rehab exercises?

Don’t do an exercise if it hurts. The first thing is to get it to stop hurting. I suggest RICE (rest, ice, compression, and elevation) for a few days until there’s no pain. Once you don’t have any pain, then you should work on strengthening exercises like clamshells and lateral leg raises.

You can run if it doesn’t hurt. If it hurts, stop. If your pain persists you may want to see a sports medicine doctor or a chiropractor who specializes in sports therapy.

I hope your IT band settles down and feels better soon. I know how frustrating and painful this injury can be.